A European study led by IDIVAL confirms fewer hernias and better quality of life without affecting oncological outcomes
The Surgical Innovation and Research Group of the Marqués de Valdecilla Health Research Institute (IDIVAL) has published a new article from the European MIRCAST project, the largest prospective multicenter study to date on minimally invasive right colectomy. The results confirm that intracorporeal anastomosis, especially when performed using robotic surgery, significantly reduces the occurrence of incisional hernias and improves quality of life in patients undergoing surgery for right colon cancer.
The MIRCAST study, launched in 2018 and led across Europe by IDIVAL, analyzed the outcomes of 1,320 patients operated on in 59 hospitals across 12 European countries. All patients were followed prospectively for two years to assess surgical complications, hernia occurrence, quality of life, and mid-term oncological outcomes.
One of the most relevant findings is that patients who underwent intracorporeal anastomosis had a significantly lower rate of incisional hernia (1.3%) compared to those in whom the anastomosis was performed outside the abdomen (extracorporeal anastomosis) (5.7%). In addition, robot-assisted surgery independently reduced the risk of hernia compared to conventional laparoscopy.
Fewer complications and better recovery for patients
The study shows that these structural advantages also translate into a better postoperative experience for patients. One year after surgery, patients demonstrated an overall improvement in quality of life, with greater improvement observed in those treated with intracorporeal anastomosis. The benefits were particularly evident in colorectal cancer–specific questionnaires, which assess aspects such as pain, bowel function, and overall well-being.
The study also highlights the importance of the type of incision used to extract the surgical specimen. The Pfannenstiel incision, more commonly used when performing intracorporeal anastomosis, was associated with a lower incidence of hernias and better quality-of-life outcomes, reinforcing the relevance of less aggressive surgical techniques from both a functional and aesthetic perspective.
From an oncological standpoint, the results confirm that these advanced techniques do not compromise treatment safety. Two-year overall survival and disease-free survival rates exceeded 95%, with no significant differences between the different surgical approaches or anastomosis techniques.
The researchers note that these new data strengthen the role of minimally invasive robotic surgery and intracorporeal anastomosis as reference techniques in right colon cancer surgery. The MIRCAST study is currently continuing with data collection and analysis, which will allow further evaluation of the long-term impact of these techniques on patients’ quality of life and oncological outcomes.
